Glaucoma affects more than 3 million Americans and is one of the leading causes of vision loss worldwide. At Barnet Dulaney Perkins Eye Center (BDP), our glaucoma specialists provide advanced diagnostic testing, innovative treatment options, and personalized care to help protect your vision.
With convenient locations throughout Arizona, including Scottsdale, Tucson, Flagstaff, Mesa, and Phoenix, our board-certified ophthalmologists utilize the latest technology to detect and manage glaucoma early, before irreversible damage occurs.
What Is Glaucoma?
Glaucoma is a group of eye diseases that damage the optic nerve, which connects your eye to your brain. Most forms are linked to elevated intraocular pressure (IOP)—a result of blocked or inefficient drainage of the eye’s natural fluid (aqueous humor). Over time, increased pressure can lead to permanent vision loss if not properly managed.
Regular eye exams are essential because glaucoma often develops without pain or noticeable symptoms until advanced stages.
Types of Glaucoma
Primary Open-Angle Glaucoma
The most common form of glaucoma, this occurs when the drainage channels in the trabecular meshwork slowly become less efficient. Pressure builds gradually, often with no early symptoms. Vision loss typically starts with the side (peripheral) vision and progresses inward.
Symptoms of Primary Open-Angle Glaucoma:
- Gradual loss of peripheral vision
- Difficulty adjusting to low light
- Tunnel vision in advanced stages
Angle-Closure (Narrow-Angle) Glaucoma
This type occurs when the iris (the colored part of the eye) is too close to the drainage angle, blocking fluid outflow. When the pupil dilates suddenly, it can close the angle entirely—causing a rapid increase in eye pressure.
Symptoms of Acute Angle-Closure Glaucoma:
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Severe eye pain and redness
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Nausea and vomiting
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Sudden blurred or hazy vision
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Halos or rainbows around lights
This is a medical emergency that requires immediate treatment to prevent permanent vision loss.
Normal-Tension Glaucoma
Even with normal eye pressure, optic nerve damage can occur due to reduced blood flow or sensitivity. Risk factors include sleep apnea, Raynaud’s disease, migraines, or genetic predisposition—more common among people of Japanese descent.
Who Is at Risk?
While anyone can develop glaucoma, the following groups face higher risk:
- Adults over 40
- African American and Asians
- Those with a family history of glaucoma
- Diabetes or high blood pressure
- Long-term steroid use
- Severe nearsightedness (myopia)
At Barnet Dulaney Perkins Eye Center, we use advanced imaging and visual field testing to detect subtle changes long before symptoms appear.
Advanced Glaucoma Treatments at Barnet Dulaney Perkins Eye Center
Although glaucoma has no cure, it is highly manageable with early diagnosis and appropriate treatment. Our doctors in Scottsdale, Tucson, Flagstaff, Mesa, and Phoenix offer the widest range of options in Arizona, including the latest laser, implant, and surgical technologies.
1. Prescription Eye Drops and Oral Medications
Most patients start with eye drops that reduce fluid production or increase drainage.
When eye drops aren’t enough, oral medications can help lower pressure further. These may include carbonic anhydrase inhibitors such as acetazolamide, typically for short-term use due to side effects.
Side effects can include redness, dryness, or mild fatigue, but your ophthalmologist will carefully monitor your tolerance and response.
2. Laser Treatments
Our clinics across Arizona perform several types of laser procedures for glaucoma management:
SLT – Selective Laser Trabeculoplasty
Selective Laser Trabeculoplasty (SLT) is a quick, in-office treatment that uses a low-energy laser to target cells in the drainage angle. SLT improves natural outflow and may reduce or eliminate the need for daily drops.
DSLT – Direct Selective Laser Trabeculoplasty
Direct Selective Laser Trabeculoplasty (DSLT) is a next-generation, non-contact laser treatment performed through the white part of the eye (sclera). It is painless, fast, and does not require anesthesia or contact lenses.
Laser Peripheral Iridotomy (LPI)
Laser Peripheral Iridotomy (LPI) uses a highly focused laser (usually YAG laser) to create a tiny hole in the peripheral iris—the colored part of the eye. This hole allows fluid (aqueous humor) to flow more freely between the front and back chambers of the eye. The goal is to equalize pressure and open the drainage angle, preventing or relieving a dangerous spike in intraocular pressure (IOP).
Micropulse and Diode Laser Treatments
Target specific areas of the ciliary body to reduce fluid production in more advanced cases while minimizing tissue damage.
3. Minimally Invasive Glaucoma Surgery (MIGS)
MIGS (Minimally Invasive Glaucoma Surgery) represents a newer generation of surgical treatments designed to lower eye pressure (intraocular pressure, or IOP) with less trauma, faster recovery, and fewer risks than traditional glaucoma surgeries like trabeculectomy or tube shunts.
Our MIGS technologies include:
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iStent® / iStent Infinite® / Hydrus® Microstent – Restores natural outflow through the trabecular meshwork.
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XEN® Gel Stent – Creates a small, permanent drainage pathway for fluid.
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OMNI®, Streamline®, iTrack®, SION®, iPrime®, VIA360® – Canaloplasty or goniotomy devices that open or bypass blocked drainage channels.
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iDose® TR – A tiny implant that delivers long-acting medication inside the eye, reducing the need for daily drops.
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Durysta® – A biodegradable implant that releases pressure-lowering medication over time.
Learn more about these devices from trusted medical sources like AAO, Glaucoma UK, and BrightFocus Foundation.
4. Traditional Glaucoma Surgeries
When medications and MIGS procedures aren’t sufficient, our surgeons perform more extensive operations to protect your vision:
Trabeculectomy
Creates a new drainage flap under the eyelid to safely relieve pressure. Opens natural drainage pathways without removing tissue, often used for angle-closure or secondary glaucoma.
Tube Shunt Surgery (Ahmed or Baerveldt Implant)
A flexible tube and plate system directs excess fluid away from the eye.
Cyclodialysis or AlloFlo Procedures
Specialized methods that enhance fluid movement or repair the existing drainage system.
Our surgeons use tissue reinforcement materials (e.g., Tutoplast sclera or pericardium, amniotic grafts, corneal patches, or Tisseel glue) for long-lasting results.
Glaucoma and Cataracts: Combined Treatment Approach
It’s common for patients to have both glaucoma and cataracts. At Barnet Dulaney Perkins, your surgeon may perform combined cataract and MIGS surgery—removing the cloudy lens while simultaneously lowering eye pressure. In mild cases, cataract surgery alone can improve fluid drainage.
Long-Term Care and Monitoring
Glaucoma requires lifelong management. Even after treatment, consistent follow-up visits allow your doctor to monitor eye pressure, optic nerve health, and medication effectiveness.
At Barnet Dulaney Perkins Eye Center, our mission is to preserve your vision with the latest technology and compassionate care from Arizona’s leading glaucoma specialists.
Schedule a Glaucoma Evaluation
If you’ve been diagnosed with glaucoma, or are at higher risk—schedule your consultation today at one of our Arizona locations in Scottsdale, Tucson, Flagstaff, Mesa, or Phoenix. Your vision matters. With early detection and personalized treatment, we can help protect it for life.